We serve faithfully!
AACN Synergy modeled acuity-based staffing. Nurse/Patient assignments are based on patient acuity, typically, 2:1 and 1:1 with hemodynamic instability
What is our staffing ratio?
Every STICU new nurse or fellow attends TNCC by 12 months and newly onboarded, experienced nurses attend by 6 months.
Prior to COVID, TCAR was offered. All charge nurses at the time attended.
What are opportunities to attend TNCC or ENPC?
What are opportunities to attend TCAR?
The standard is 13 RNs per shift and we float ro CTICU, MICU, NsICU, APSICU, and occasionally ED, AC, CCH, and PICU.
What is "How many nurses on shift? Do STICU nurses float to other ICUs?"
Trauma surgeons treat us well.
What is a collaborative effort? What is a teaching environment? What is nursing advocacy and provider support?
19 patients
What is our STICU average daily census?
Trauma patients, blunt trauma is the majority of the population (falls, MVC), snakebites, and penetrating trauma from time to time. Higher acuity surgical patients including Neuro, ENT head/neck, thoracic, bariatric, kidney/pancreas transplant, and vascular
What types of patients do you care for?
What is the ICU code blue on-call unit?
Multidisciplinary team rounds (critical care team rounds (CCTR) occur daily in the AM, starting at 0830.
How do you communicate issues to the MD in the morning? Rounds?
We have the Hotline and Level 1 transfuse.
What is "What type of blood warmers do you have?"
10-12 patients
What is our STICU average daily intubated census?
Crainotomy/ectomy--TBI, SDH, SAH, IPH, herniation, burr hole, EVD; Thoracotomy--trauma, empyema, lobectomy, CTube, Malignant & non tumors; Glossectomy-oral ca; Esophagectomy- cancer, fistula; Exp Lap-dead bowel, obstruction, trauma; Vascular--AAA, fempop/femfem bypass, thrombectomy, Transplant--kidney/panc, STA
What are the common STICU diagnoses and surgeries?
I seek clarity and support from the charge nurse, nurse supervisor/house supervisor, on-call nurse manager.
I seek clarity and support from the Resident, attending, medical director, chief of service, assistant CMO, CMO
I seek clarity and support from the admitting team resident, attending, medical director
Also, available the in-house, on-call trauma surgeon and ETS resident
When I have troubles during the night, who do I go to first? What is the critical care escalation process or chain of command?
24/7 nursing, assistive personnel (PCTs), respiratory therapy; Resident is on the unit at all times, in-house ETS resident; on-call attending, on-call in-house trauma surgeon
Who is here all the time? Who is here part of the time?
What is certification reimbursement? What is the Level Up program? What is the unit certification rate?
The goal is for the charge nurse to be free but will be in staffing based on unit acuity and overall ICU staffing shortages.
What is the charge nurse role and responsibility?
CVAD, Arterial line, Chest tube, Tracheostomy, PEG, Upper & Lower Endoscopy, External Fixation, EVD, Open Abdomen
What are the common bedside procedures in STICU?
I call to bedside, nursing team, respiratory therapy, the STICU resident, and possibly anesthesia on-call, ENT on-call, on-call attending.
Who do you call if you have an airway issue at night?
I seek clarity and support from the charge nurse, nurse supervisor/house supervisor, nurse manager.
I seek clarity and support from the Resident, attending, medical director, chief of service, assistant CMO, CMO
I seek clarity and support from the admitting team resident, attending, medical director
When you have trouble during the day, who do you go to first? What is follow the critical care escalation process or chain of command?
We have CRRT capabilities with a designated nurse to manage.
What is a dialysis nurse (from dialysis dept. and they also take overnight call)?
The STICU charge nurse carries a trauma pager and will go down to the ED for 911 activations. The STICU charge nurse response time to ED is timed with the alerted ETA.
What is "does the ICU get trauma pages to alert"?
CT scan, MRI, 3D ENDO, Cath lab, & Nuclear Med
What is critical transport (RN and possibly other healthcare team member accompanied)?
I call a code by pushing the in-room "code blue button" to activate the my nursing team and the hospital code blued team; the team includes, the our STICU resident, anesthesia, ETS resident, on-call code blue nurse, respiratory therapy, and all ancillary teams (EKG, phlebotomy, radiology, security, hospital supervisor, and chaplain). Also, called...In-house trauma surgeon and on-call attending if necessary
Who do you call if you have code at night?
All 911 trauma patients are swabbed/tested for COVID unless hemodynamically unstable and rushed to OR. Testing is completed later. For 922 trauma patients, the patient is screened and swabbed/tested if there is known exposure or signs/symptoms. Trauma patients that are positive for COVID are admitted to the STICU. All ICU rooms can be converted to negative pressure.
What is the COVID protocol for trauma patients? When screened? Where admitted if positive?
There are free trauma CEs via Mosby's and Nursing Reference Center. Prior to COVID, an annual trauma Conference was offered.
What is available trauma education and required annual trauma education hours?
The primary nurse, transport, ETS, and respiratory.
Who accompanies patient if they go to OR or CT (on a road trip)?